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1.
Br J Nurs ; 30(20): 1198-1202, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1513210

ABSTRACT

The COVID-19 pandemic has affected the delivery of nursing training in higher education and how workforce development programmes are delivered. Using simulated practice is an opportunity for experiential and immersive learning in a safe and supported environment that replaces real life. This article discusses the use of simulation in nurse education to improve patient safety.


Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Simulation Training , Students, Nursing , Clinical Competence , Humans , Pandemics , Patient Safety , Patient Simulation , SARS-CoV-2
3.
J Am Coll Radiol ; 18(7): 1050-1052, 2021 07.
Article in English | MEDLINE | ID: covidwho-1492202

Subject(s)
Patient Safety , Humans
4.
Clin Orthop Relat Res ; 479(10): 2111-2112, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1483563
7.
J Perioper Pract ; 30(6): 151, 2020 06.
Article in English | MEDLINE | ID: covidwho-1477003
10.
Acta Myol ; 40(3): 113-115, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1464223

ABSTRACT

COVID-19 outbreak has quickly reached alarming morbidity and mortality with vaccines being the only weapon to fight. Although the critical situation, no international guidelines on the vaccination management of patients with neuromuscular disorders (NMDs) has still been issued. We aimed to address some unmet needs about the management of COVID-19 vaccination in patients with NMDs.


Subject(s)
COVID-19 Vaccines/administration & dosage , Health Services Needs and Demand , Neuromuscular Diseases , Female , Humans , Male , Pandemics , Patient Safety , SARS-CoV-2
11.
Cells ; 10(10)2021 10 11.
Article in English | MEDLINE | ID: covidwho-1463567

ABSTRACT

As of September 2021, twenty-one anti-COVID-19 vaccines have been approved in the world. Their utilization will expedite an end to the current pandemic. Besides the usual vaccine formats that include inactivated viruses (eight approved vaccines) and protein-based vaccines (four approved vaccines), three new formats have been validated: recombinant adenovirus (six approved vaccines), DNA (one approved vaccine), and messenger RNA (mRNA, two approved vaccines). The latter was the fastest (authorized in 2020 in the EU, the USA, and Switzerland). Most Western countries have reserved or use the protein vaccines, the adenovirus vaccines, and mRNA vaccines. I describe here the different vaccine formats in the context of COVID-19, detail the three formats that are chiefly reserved or used in Europe, Canada, and the USA, and discuss why the mRNA vaccines appear to be the superior format.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/prevention & control , RNA, Messenger , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/genetics , Adenoviridae/genetics , Animals , Canada , DNA/genetics , Drug Approval , Europe , Humans , Mice , Patient Safety , United States
12.
J Vasc Interv Radiol ; 32(1): 33-38, 2021 01.
Article in English | MEDLINE | ID: covidwho-1454337

ABSTRACT

PURPOSE: To determine effect of body mass index (BMI) on safety and cancer-related outcomes of thermal ablation for renal cell carcinoma (RRC). MATERIALS AND METHODS: This retrospective study evaluated 427 patients (287 men and 140 women; mean [SD] age, 72 [12] y) who were treated with thermal ablation for RCC between October 2006 and December 2017. Patients were stratified by BMI into 3 categories: normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥ 30 kg/m2). Of 427 patients, 71 (16%) were normal weight, 157 (37%) were overweight, and 199 (47%) were obese. Complication rates, local recurrence, and residual disease were compared in the 3 cohorts. RESULTS: No differences in technical success between normal-weight, overweight, and obese patients were identified (P = .72). Primary technique efficacy rates for normal-weight, overweight, and obese patients were 91%, 94%, and 93% (P = .71). There was no significant difference in RCC specific-free survival, disease-free survival, and metastasis-free survival between obese, overweight, and normal-weight groups (P = .72, P = .43, P = .99). Complication rates between the 3 cohorts were similar (normal weight 4%, overweight 2%, obese 3%; P = .71). CONCLUSIONS: CT-guided renal ablation is safe, feasible, and effective regardless of BMI.


Subject(s)
Body Mass Index , Carcinoma, Renal Cell/surgery , Cryosurgery , Kidney Neoplasms/surgery , Microwaves/therapeutic use , Obesity/diagnosis , Radiofrequency Ablation , Aged , Aged, 80 and over , Carcinoma, Renal Cell/mortality , Carcinoma, Renal Cell/secondary , Cryosurgery/adverse effects , Cryosurgery/mortality , Disease Progression , Disease-Free Survival , Female , Humans , Kidney Neoplasms/mortality , Kidney Neoplasms/pathology , Male , Microwaves/adverse effects , Middle Aged , Neoplasm Recurrence, Local , Obesity/mortality , Patient Safety , Radiofrequency Ablation/adverse effects , Radiofrequency Ablation/mortality , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome
13.
BMC Health Serv Res ; 20(1): 101, 2020 Feb 10.
Article in English | MEDLINE | ID: covidwho-1455959

ABSTRACT

BACKGROUND: Having psychologically safe teams can improve learning, creativity and performance within organisations. Within a healthcare context, psychological safety supports patient safety by enabling engagement in quality improvement and encouraging staff to speak up about errors. Despite the low levels of psychological safety in healthcare teams and the important role it plays in supporting patient safety, there is a dearth of research on interventions that can be used to improve psychological safety or its related constructs. This review synthesises the content, theoretical underpinnings and outcomes of interventions which have targeted psychological safety, speaking up, and voice behaviour within a healthcare setting. It aims to identify successful interventions and inform the development of more effective interventions. METHODS: A key word search strategy was developed and used to search electronic databases (PsycINFO, ABI/Inform, Academic search complete and PubMed) and grey literature databases (OpenGrey, OCLC WorldCat, Espace). Covidence, an online specialised systematic review website, was used to screen records. Data extraction, quality appraisal and narrative synthesis were conducted on identified papers. RESULTS: Fourteen interventions were reviewed. These interventions fell into five categories. Educational interventions used simulation, video presentations, case studies and workshops while interventions which did not include an educational component used holistic facilitation, forum play and action research meetings. Mixed results were found for the efficacy or effectiveness of these interventions. While some interventions showed improvement in outcomes related to psychological safety, speaking up and voice, this was not consistently demonstrated across interventions. Included interventions' ability to demonstrate improvements in these outcomes were limited by a lack of objective outcome measures and the ability of educational interventions alone to change deeply rooted speaking up behaviours. CONCLUSION: To improve our understanding of the efficacy or effectiveness of interventions targeting psychological safety, speaking up and voice behaviour, longitudinal and multifaceted interventions are needed. In order to understand whether these interventions are successful, more objective measures should be developed. It is recommended that future research involves end users in the design phase of interventions, target both group and organisational levels, ensure visible leader support and work across and within interdisciplinary teams. PROSPERO REGISTRATION NUMBER: CRD42018100659.


Subject(s)
Health Personnel/psychology , Interprofessional Relations , Patient Care Team/organization & administration , Safety , Humans , Patient Safety
14.
Int J Qual Health Care ; 32(4): 240-250, 2020 Jun 04.
Article in English | MEDLINE | ID: covidwho-1455317

ABSTRACT

PURPOSE: The current systematic review will identify enablers of psychological safety within the literature in order to produce a comprehensive list of factors that enable psychological safety specific to healthcare teams. DATA SOURCES: A keyword search strategy was developed and used to search the following electronic databases PsycINFO, ABI/INFORM, Academic search complete and PubMed and grey literature databases OpenGrey, OCLC WorldCAT and Espace. STUDY SELECTION: Peer-reviewed studies relevant to enablers of psychological safety in healthcare setting that were published between 1999 and 2019 were eligible for inclusion. Covidence, an online specialized systematic review website, was used to screen records. Data extraction, quality appraisal and narrative synthesis were conducted on identified papers. DATA EXTRACTION: Thirty-six relevant studies were identified for full review and data extraction. A data extraction template was developed and included sections for the study methodology and the specific enablers identified within each study. RESULTS OF DATA SYNTHESIS: Identified studies were reviewed using a narrative synthesis. Within the 36 articles reviewed, 13 enablers from across organizational, team and individual levels were identified. These enablers were grouped according to five broader themes: priority for patient safety, improvement or learning orientation, support, familiarity with colleagues, status, hierarchy and inclusiveness and individual differences. CONCLUSION: This systematic review of psychological safety literature identifies a list of enablers of psychological safety within healthcare teams. This list can be used as a first step in developing observational measures and interventions to improve psychological safety in healthcare teams.


Subject(s)
Patient Care Team , Patient Safety , Delivery of Health Care , Humans , Learning
15.
Int J Nurs Stud ; 109: 103658, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1454195

ABSTRACT

BACKGROUND: Nursing literature frequently emphasises the benefits of person-centred approaches for healthcare quality and safety. OBJECTIVE: This umbrella review aimed to synthesise the combined evidence from systematic reviews assessing the impact of person-centred care interventions on patient safety. DESIGN: A three-step review process included a preliminary review of literature, a comprehensive search, and manual searching of reference lists and forward citations of selected reviews. The review protocol was registered with Prospero (CRD42018090048). DATA SOURCES: Reviewers searched 10 databases for systematic reviews published in English-language peer-reviewed journals between 2000 and 2019: Academic Search Complete, CINAHL, Cochrane Library, EMBASE, JBI Database, Medline, ProQuest Health & Medicine, PROSPERO Register, PubMed and Scopus. REVIEW METHODS: Covidence software was used to manage screening and eligibility. Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS: From an initial total of 3412 potential titles, 16 reviews met the inclusion criteria. The selected reviews examined the impact of person-centred care for diverse groups of patients (children, adults and older people) in varied settings. Most systematic reviews assessed experimental studies, generally comparing person-centred interventions with 'usual care', often demonstrating limited evidence of impact on safety. Reviews addressed several patient safety outcomes relevant to nursing, including falls, infections, medication use and misuse, and mortality rates. The systematic reviews were generally well conducted, although several included studies of poor or fair quality. Given the heterogeneity of the interventions, outcomes and research designs of studies included in the selected reviews, we were unable to draw unequivocal conclusions about the implications of person-centred care for patient safety in this umbrella review. However, there was some encouraging evidence that person-centred care initiatives may result in reduced rates of falls (in acute care and residential aged care settings). The review also highlighted reductions in agitation for people with dementia and some improvement in anti-psychotic medication use in older people with dementia. CONCLUSIONS: Although abundant evidence exists demonstrating the positive effects of person-centred care on healthcare quality and on patient (and provider) wellbeing, there is little research focussing specifically on the impact of person-centred care on patient safety. Thus, there is scope for further high-quality nursing research into how person-centred interventions improve specific patient safety outcomes in order to inform more widespread adoption of person-centred practice.


Subject(s)
Nursing Research , Adult , Aged , Child , Delivery of Health Care , Humans , Patient Safety , Patient-Centered Care , Systematic Reviews as Topic
16.
Nursing ; 51(10): 42-48, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1440657

ABSTRACT

ABSTRACT: Patient safety attendants (PSAs) provide constant direct observation to patients who have cognitive impairments or thoughts. Some estimates report that an acute care hospital in the United States may spend more than $1 million annually on PSAs, an expenditure often not reimbursed. With no national defined standards to regulate or monitor PSA use, this study sought to determine the impact of COVID-19 on a PSA reduction program in a large Midwestern healthcare system.


Subject(s)
Allied Health Personnel/statistics & numerical data , COVID-19/epidemiology , Patient Safety , Allied Health Personnel/economics , Cognitive Dysfunction/nursing , Humans , Midwestern United States/epidemiology , Program Evaluation
17.
Pharmaceut Med ; 35(5): 287-295, 2021 09.
Article in English | MEDLINE | ID: covidwho-1439797

ABSTRACT

Pharmaceutical development was at the forefront of efforts to prevent infection with the SARS-CoV-2 virus as well as to treat its often-devastating effects. Drug development, and its multifaceted and multi-disciplined activity toward effective vaccines and drugs, became part of everyday news. I review several key areas of vaccine and drug development that were brought into the public mainstream over the evolution of the pandemic. These include the unprecedented speed of vaccine discovery and development, issues uncovered from early clinical studies, and regulatory concepts that were highlighted throughout the development process. Among these was the importance of pharmacovigilance as each new agent was rapidly deployed to a mostly eager public. Critical challenges around production, packaging, and procurement of product for patient use were often centre stage. Finally, the ever-important need to transition not only from scientific concept to vaccine and drug, but from their authorized and approved use to their implementation in health systems to insure the intended effects both in individuals and populations.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Drug Approval , Drug Development , Drug Discovery , Global Health , Animals , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/supply & distribution , Drug Packaging , Health Knowledge, Attitudes, Practice , Humans , Patient Safety , Public Opinion , Risk Assessment , Risk Factors
18.
Cells ; 10(10)2021 09 26.
Article in English | MEDLINE | ID: covidwho-1438527

ABSTRACT

Specific memory B cells and antibodies are a reliable read-out of vaccine efficacy. We analysed these biomarkers after one and two doses of BNT162b2 vaccine. The second dose significantly increases the level of highly specific memory B cells and antibodies. Two months after the second dose, specific antibody levels decline, but highly specific memory B cells continue to increase, thus predicting a sustained protection from COVID-19. We show that although mucosal IgA is not induced by the vaccination, memory B cells migrate in response to inflammation and secrete IgA at mucosal sites. We show that the first vaccine dose may lead to an insufficient number of highly specific memory B cells and low concentration of serum antibodies, thus leaving vaccinees without the immune robustness needed to ensure viral elimination and herd immunity. We also clarify that the reduction of serum antibodies does not diminish the force and duration of the immune protection induced by vaccination. The vaccine does not induce sterilizing immunity. Infection after vaccination may be caused by the lack of local preventive immunity because of the absence of mucosal IgA.


Subject(s)
Antibodies, Viral/immunology , B-Lymphocytes/cytology , COVID-19 Vaccines/therapeutic use , COVID-19/immunology , COVID-19/prevention & control , Immunoglobulin A/immunology , Immunologic Memory , Adult , Antibodies, Neutralizing/blood , Antigens, Viral/immunology , B-Lymphocytes/immunology , Cryopreservation , Female , Health Personnel , Healthy Volunteers , Hospitals, Pediatric , Humans , Immunoglobulin G , Immunoglobulin M/immunology , Lactation , Male , Middle Aged , Mucous Membrane/immunology , Patient Safety , SARS-CoV-2 , Vaccination
19.
Eur J Obstet Gynecol Reprod Biol ; 266: 111-113, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1433181

ABSTRACT

Maternal morbidity and mortality remain stubborn highly in many parts of the world. Similarly Neonatal morbidity, mortality and five years survival in most of the under-resourced countries has not declined significantly over the past decades. Furthermore sexual reproductive health services provision has not met the needs of the women and there remains a huge unmet need for reliable contraception globally. This is the time for a global action plan and for all agencies to work together to achieve meaningful outcomes to improve health of women and their babies. Covid 19 pandemic has led to increase in gender based violence as well which is deplorable. European Board and College of Obstetrics and Gynaecology welcome this initiative and commits to work with all the stakeholders to improve safety and quality of care for women and the newborn.


Subject(s)
COVID-19 , Gynecology , Obstetrics , Female , Humans , Infant, Newborn , Patient Safety , Pregnancy , SARS-CoV-2
20.
J Child Adolesc Psychopharmacol ; 31(7): 464-474, 2021 09.
Article in English | MEDLINE | ID: covidwho-1429159

ABSTRACT

Objectives: To describe the development of a protocol and practical tool for the safe delivery of telemental health (TMH) services to the home. The COVID-19 pandemic forced providers to rapidly transition their outpatient practices to home-based TMH (HB-TMH) without existing protocols or tools to guide them. This experience underscored the need for a standardized privacy and safety tool as HB-TMH is expected to continue as a resource during future crises as well as to become a component of the routine mental health care landscape. Methods: The authors represent a subset of the Child and Adolescent Psychiatry Telemental Health Consortium. They met weekly through videoconferencing to review published safety standards of care, existing TMH guidelines for clinic-based and home-based services, and their own institutional protocols. They agreed on three domains foundational to the delivery of HB-TMH: environmental safety, clinical safety, and disposition planning. Through multiple iterations, they agreed upon a final Privacy and Safety Protocol for HB-TMH. The protocol was then operationalized into the Privacy and Safety Assessment Tool (PSA Tool) based on two keystone medical safety constructs: the World Health Organization (WHO) Surgical Safety Checklist/Time-Out and the Checklist Manifesto. Results: The PSA Tool comprised four modules: (1) Screening for Safety for HB-TMH; (2) Assessment for Safety During the HB-TMH Initial Visit; (3) End of the Initial Visit and Disposition Planning; and (4) the TMH Time-Out and Reassessment during subsequent visits. A sample workflow guides implementation. Conclusions: The Privacy and Safety Protocol and PSA Tool aim to prepare providers for the private and safe delivery of HB-TMH. Its modular format can be adapted to each site's resources. Going forward, the PSA Tool should help to facilitate the integration of HB-TMH into the routine mental health care landscape.


Subject(s)
Adolescent Health Services/organization & administration , COVID-19 , Child Health Services/organization & administration , Clinical Protocols/standards , Home Care Services , Mental Health Services/organization & administration , Patient Safety , Privacy , Telemedicine , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Child , Computer Communication Networks/standards , Delivery of Health Care/methods , Delivery of Health Care/organization & administration , Home Care Services/ethics , Home Care Services/standards , Home Care Services/trends , Humans , SARS-CoV-2 , Telemedicine/ethics , Telemedicine/methods , United States
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